Diagnosis and management of cellulitis

@article{Phoenix2012DiagnosisAM,
  title={Diagnosis and management of cellulitis},
  author={Gokulan Phoenix and Saroj Kumar Das and Meera Joshi},
  journal={BMJ : British Medical Journal},
  year={2012},
  volume={345}
}
#### Summary points Cellulitis is an acute, spreading, pyogenic inflammation of the lower dermis and associated subcutaneous tissue. [] Key Method#### Sources and selection criteria We searched PubMed and the Cochrane library for recent and clinically relevant cohort studies and randomised controlled trials on cellulitis, using the search terms “cellulitis”, “erysipelas”, “diagnosis”, “investigation”, “recurrence”, “complications” and “management”.

Diagnosis and management of cellulitis and erysipelas.

TLDR
Large-scale controlled trial evidence for specific antimicrobial choices in the treatment of cellulitis and erysipelas is lacking, with national and local guidelines being based on a combination of best evidence, local epidemiology data and expert opinion.

Cellulitis: A Review.

TLDR
Treating predisposing factors can minimize risk of recurrence of cellulitis, and treatment of uncomplicated cellulitis should be directed against Streptococcus and methicillin-sensitive S. aureus.

A Retrospective Study: Erysipelas and Cellulitis Patients’ Profile

TLDR
The correct management could increase the recovery rate, prevent complication and recurrency of erysipelas and cellulitis, and determine a general overview as well as predictive factors of the severity of this acute infectious disease.

The Profile of Erysipelas and Cellulitis Patients

TLDR
The management of patients with erysipelas and cellulitis had been appropriate based on the diagnosis and treatment guidelines.

Diagnosis and treatment of the invasive extension of bacteria (cellulitis) from chronic wounds utilising point‐of‐care fluorescence imaging

TLDR
The utility of point‐of‐care fluorescence imaging for efficient detection and proactive, targeted management of wound‐related cellulitis is demonstrated.

Cellulitis, by any other name.

  • H. Chambers
  • Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2013
“I know it when I see it . . . ,” as Justice Potter Stewart famously said of hard-core pornography. Would that this were the case with cellulitis. In principle, cellulitis is simply defined as an

Risk factors and complications of lower limb cellulitis in Africa: a systematic review

TLDR
The identification and improved management of the risk factors and factors associated with complications of lower limb cellulitis and its complications could go a long way in decreasing the morbidity and health costs incurred by lower limbs cellulitis in Africa.

Reducing Unnecessary Testing in Uncomplicated Skin and Soft Tissue Infections: A Quality Improvement Approach.

TLDR
A interdisciplinary team led a quality improvement project reducing unnecessary laboratory testing in patients with an uSSTI without patient harm, achieving their aim.

Evaluation of Antibiotic Treatment on the Duration of Hospitalization of Patients with Erysipelas and Bacterial Cellulitis

TLDR
It is suggested that this combination therapy with amoxicillin + clavulanic acid should be considered as a first-line treatment for patients hospitalized due to erysipelas or bacterial cellulitis, if other factors did not preclude the use of this therapy.

References

SHOWING 1-10 OF 36 REFERENCES

Interventions for cellulitis and erysipelas.

TLDR
There is a need for trials to evaluate the efficacy of oral antibiotics against intravenous antibiotics in the community setting as there are service implications for cost and comfort.

Practice guidelines for the diagnosis and management of skin and soft-tissue infections.

  • D. StevensA. Bisno J. Wade
  • Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2005
TLDR
It is the recommendation of this committee that patients with soft-tissue infection be distinguished by signs and symptoms of systemic toxicity (e.g., fever or hypothermia, tachycardia [heart rate,] and so on).

Severity assessment of skin and soft tissue infections: cohort study of management and outcomes for hospitalized patients.

TLDR
SSTI in hospital is associated with significant mortality, and choice of empirical therapy is not evidence based, with significant under-treatment of severely ill patients.

Management and morbidity of cellulitis of the leg

TLDR
Important but often neglected therapeutic suggestions are the inclusion of benzylpenicillin in all cases without a contraindication, assessment and treatment of tinea pedis, use of support hosiery, and serological testing for streptococci to confirm the diagnosis in retrospect.

Diagnostic accuracy in patients admitted to hospitals with cellulitis.

TLDR
The capability of this VCDDSS to assist primary care physicians with generating a more accurate differential diagnosis (DDx) when confronted with patients presenting with possible skin infections is demonstrated.

The effect of soft-tissue ultrasound on the management of cellulitis in the emergency department.

TLDR
Soft-tissue US changes physician management in approximately half of patients in the ED with clinical cellulitis, which may guide management of cellulitis by detection of occult abscess, prevention of invasive procedures, and guidance for further imaging or consultation.

Staphylococcus aureus is the most common identified cause of cellulitis: a systematic review

TLDR
The most common aetiology of cellulitis with intact skin, when it can be determined, is S. aureus, outnumbering group A streptococcus by a ratio of nearly 2:1.

Cost-effectiveness of blood cultures for adult patients with cellulitis.

TLDR
The yield of blood cultures is very low, has a marginal impact on clinical management, and does not appear to be cost-effective for most patients with cellulitis.

Tetracyclines as an Oral Treatment Option for Patients with Community Onset Skin and Soft Tissue Infections Caused by Methicillin-Resistant Staphylococcus aureus

TLDR
The expanded-spectrum tetracyclines appear to be a reasonable oral treatment option for patients with community onset MRSA SSTI in areas where MRSA strains are susceptible to the tetrACYclines.

Microbiologic evaluation of cutaneous cellulitis in adults.

TLDR
Clinical features, including temperature, white blood cell count, and erythrocyte sedimentation rate, were not predictive of positive aspirate, biopsy, or blood cultures.